{"id":2724,"date":"2024-07-08T17:01:05","date_gmt":"2024-07-08T10:01:05","guid":{"rendered":"https:\/\/victoriavn.com\/e-voucher\/?page_id=2724"},"modified":"2025-04-03T15:14:06","modified_gmt":"2025-04-03T08:14:06","slug":"khao-sat-danh-gia-chat-luong-phuc-vu-va-nhan-uu-dai-ver-2-en","status":"publish","type":"page","link":"https:\/\/victoriavn.com\/e-voucher\/khao-sat-danh-gia-chat-luong-phuc-vu-va-nhan-uu-dai-ver-2-en\/","title":{"rendered":"Kh\u1ea3o s\u00e1t \u0111\u00e1nh gi\u00e1 ch\u1ea5t l\u01b0\u1ee3ng ph\u1ee5c v\u1ee5 v\u00e0 nh\u1eadn \u01b0u \u0111\u00e3i Ver 2 &#8211; EN"},"content":{"rendered":"<div class=\"row row-collapse row-full-width\"  id=\"row-1301891702\">\n\n\t<div id=\"col-789972320\" class=\"col small-12 large-12\"  >\n\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t<section class=\"section\" id=\"section_96416948\">\n\t\t<div class=\"bg section-bg fill bg-fill  \" >\n\n\t\t\t\n\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n<div class=\"row row-collapse align-center\" style=\"max-width:\" id=\"row-1135609842\">\n\n\t<div id=\"col-767552778\" class=\"col small-12 large-12\"  >\n\t\t<div class=\"col-inner text-center dark\"  >\n\t\t\t\n\t\t\t\n<div class=\"row\"  id=\"row-1823259658\">\n\n\t<div id=\"col-1385737161\" class=\"col small-12 large-12\"  >\n\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t<div id=\"gap-2030637438\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-2030637438 {\n  padding-top: 30px;\n}\n<\/style>\n\t<\/div>\n\t\n\t<div id=\"gap-487781771\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-487781771 {\n  padding-top: 40%;\n}\n<\/style>\n\t<\/div>\n\t\n\t\t<\/div>\n\t\t\t<\/div>\n\n\t\n<\/div>\n\t\t<\/div>\n\t\t\n<style>\n#col-767552778 > .col-inner {\n  padding: 0px 0px 0px 0px;\n}\n@media (min-width:550px) {\n  #col-767552778 > .col-inner {\n    padding: 100px 0px 200px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n<\/div>\n\t\t<\/div>\n\n\t\t\n<style>\n#section_96416948 {\n  padding-top: 0px;\n  padding-bottom: 0px;\n  min-height: 0px;\n}\n#section_96416948 .section-bg-overlay {\n  background-color: rgba(0, 0, 0, 0.12);\n}\n#section_96416948 .section-bg.bg-loaded {\n  background-image: url(https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2021\/11\/cs-01-scaled.jpg);\n}\n#section_96416948 .section-bg {\n  background-position: 42% 53%;\n}\n@media (min-width:550px) {\n  #section_96416948 {\n    padding-top: 0px;\n    padding-bottom: 0px;\n    min-height: 0px;\n  }\n  #section_96416948 .section-bg-overlay {\n    background-color: rgba(0, 0, 0, 0.21);\n  }\n}\n@media (min-width:850px) {\n  #section_96416948 {\n    padding-top: 0px;\n    padding-bottom: 0px;\n  }\n}\n<\/style>\n\t<\/section>\n\t\n\t\t<\/div>\n\t\t\t<\/div>\n\n\t\n<\/div>\n<div class=\"row row-large\" style=\"max-width:1400px\" id=\"row-1926543613\">\n\n\t<div id=\"col-212386926\" class=\"col small-12 large-12\"  >\n\t\t<div class=\"col-inner\" style=\"background-color:rgb(255, 255, 255);\" >\n\t\t\t\n\t\t\t\n<div class=\"row row-collapse row-full-width\"  id=\"row-1136439877\">\n\n\t<div id=\"col-2123499020\" class=\"col medium-12 small-12 large-12\"  >\n\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-296 aligncenter\" src=\"https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2020\/11\/logo_victora-01-800x239.png\" alt=\"\" width=\"244\" height=\"73\" srcset=\"https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2020\/11\/logo_victora-01-800x239.png 800w, https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2020\/11\/logo_victora-01-510x152.png 510w, https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2020\/11\/logo_victora-01-768x229.png 768w, https:\/\/victoriavn.com\/e-voucher\/wp-content\/uploads\/2020\/11\/logo_victora-01.png 1070w\" sizes=\"auto, (max-width: 244px) 100vw, 244px\" \/><\/p>\n<div class=\"container section-title-container\" ><h3 class=\"section-title section-title-center\"><b><\/b><span class=\"section-title-main\" style=\"color:rgb(0, 142, 132);\">Share your experience with our service<\/span><b><\/b><\/h3><\/div>\n\t<div id=\"gap-406765378\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-406765378 {\n  padding-top: 20px;\n}\n@media (min-width:550px) {\n  #gap-406765378 {\n    padding-top: 20px;\n  }\n}\n@media (min-width:850px) {\n  #gap-406765378 {\n    padding-top: 30px;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2772-o1\" lang=\"vi\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/e-voucher\/wp-json\/wp\/v2\/pages\/2724#wpcf7-f2772-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"2772\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.7.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"vi\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2772-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:2772,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;group-nguon-kenh-xuathien&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;nguon-khach-hang&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other (please specify)&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false}}\" \/>\n<\/div>\n<p><span class=\"wpcf7-form-control-wrap submission_id-ma_uu_dai\"><input class=\"wpcf7-form-control wpcf7-submission_id_hidden wpcf7-validates-as-number\" readonly=\"readonly\" aria-invalid=\"false\" value=\"VHC0768\" name=\"submission_id-ma_uu_dai\" type=\"hidden\" \/><\/span><br \/>\nQuestion 1. How satisfied are you with the attentiveness and guidance provided by the customer service staff throughout your visit?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cau-1\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"cau-1\" value=\"Very dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-1\" value=\"Dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-1\" value=\"Neutral\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-1\" value=\"Satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Satisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"cau-1\" value=\"Very satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very satisfied<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Question 2. How satisfied are you with the examination and consultation process conducted by the doctor?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cau-2\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"cau-2\" value=\"Very dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-2\" value=\"Dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-2\" value=\"Neutral\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-2\" value=\"Satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Satisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"cau-2\" value=\"Very satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very satisfied<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Question 3. How satisfied are you with the support, care, and guidance provided by the nurses throughout your medical visit?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cau-3\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"cau-3\" value=\"Very dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-3\" value=\"Dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-3\" value=\"Neutral\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-3\" value=\"Satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Satisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"cau-3\" value=\"Very satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very satisfied<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Question 4. How would you assess the effectiveness of your digital medical record systems (Patient Portal) at Victoria Healthcare?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cau-4\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"cau-4\" value=\"Very dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-4\" value=\"Dissatisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Dissatisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-4\" value=\"Neutral\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-4\" value=\"Satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Satisfied<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"cau-4\" value=\"Very satisfied\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">Very satisfied<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Question 5. On a scale of 1 to 5, how likely are you to recommend our clinic to your friends or family members?<br \/>\n(1 - Not likely at all, 5 - Extremely likely to recommend)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cau-5\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"cau-5\" value=\"1\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-5\" value=\"2\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-5\" value=\"3\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"cau-5\" value=\"4\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"cau-5\" value=\"5\" tabindex=\"\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span><br \/>\nThrough which of the following channels did you learn about Victoria Healthcare?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nguon-khach-hang\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><span class=\"wpcf7-list-item-label\">Facebook<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Facebook\" tabindex=\"\" \/><\/label><\/span><span class=\"wpcf7-list-item\"><label><span class=\"wpcf7-list-item-label\">Google<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Google\" tabindex=\"\" \/><\/label><\/span><span class=\"wpcf7-list-item\"><label><span class=\"wpcf7-list-item-label\">Existing customer<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Existing customer\" tabindex=\"\" \/><\/label><\/span><span class=\"wpcf7-list-item\"><label><span class=\"wpcf7-list-item-label\">Corporate health check-up<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Corporate health check-up\" tabindex=\"\" \/><\/label><\/span><span class=\"wpcf7-list-item\"><label><span class=\"wpcf7-list-item-label\">Recommended by friends or acquaintances<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Recommended by friends or acquaintances\" tabindex=\"\" \/><\/label><\/span><span class=\"wpcf7-list-item last\"><label><span class=\"wpcf7-list-item-label\">Other (please specify)<\/span><input type=\"radio\" name=\"nguon-khach-hang\" value=\"Other (please specify)\" tabindex=\"\" \/><\/label><\/span><\/span><\/span>\n<\/p>\n<div data-id=\"group-nguon-kenh-xuathien\" data-orig_data_id=\"group-nguon-kenh-xuathien\"  data-class=\"wpcf7cf_group\">\n\t<p>Please specify, e.g., SMS, LinkedIn, Event, etc.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"noi-dung-nguon-khac\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"noi-dung-nguon-khac\"><\/textarea><\/span>\n\t<\/p>\n<\/div>\n<p>Question 6. Your feedback is invaluable in helping us enhance the quality of our healthcare services.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"y-kien-dong-gop\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"y-kien-dong-gop\"><\/textarea><\/span>\n<\/p>\n<p data-start=\"55\" data-end=\"131\"><strong data-start=\"55\" data-end=\"131\">We sincerely thank you for taking the time to participate in our survey.<\/strong>\n<\/p>\n<p data-start=\"133\" data-end=\"270\">As a token of our appreciation, you will receive a <strong data-start=\"184\" data-end=\"221\">10% discount on consultation fees<\/strong> for your next visit after completing the survey.\n<\/p>\n<p data-start=\"272\" data-end=\"299\"><strong data-start=\"272\" data-end=\"297\">Terms and Conditions:<\/strong>\n<\/p>\n<ul data-start=\"300\" data-end=\"661\">\n\t<li data-start=\"300\" data-end=\"404\">\n\t\t<p data-start=\"302\" data-end=\"404\">The offer is applied to listed consultation prices and <strong data-start=\"357\" data-end=\"401\">cannot be combined with other promotions<\/strong>.\n\t\t<\/p>\n\t<\/li>\n\t<li data-start=\"405\" data-end=\"473\">\n\t\t<p data-start=\"407\" data-end=\"473\"><strong data-start=\"407\" data-end=\"425\">Not applicable<\/strong> to medication, vaccines, or medical supplies.\n\t\t<\/p>\n\t<\/li>\n\t<li data-start=\"474\" data-end=\"562\">\n\t\t<p data-start=\"476\" data-end=\"562\">The offer is <strong data-start=\"489\" data-end=\"510\">valid for 30 days<\/strong> from the date you receive the confirmation email.\n\t\t<\/p>\n\t<\/li>\n\t<li data-start=\"563\" data-end=\"661\">\n\t\t<p data-start=\"565\" data-end=\"661\"><strong data-start=\"565\" data-end=\"646\">Please present the email containing the discount code at the time of check-in<\/strong> at the clinic.\n\t\t<\/p>\n\t<\/li>\n<\/ul>\n<p data-start=\"663\" data-end=\"727\">Please complete the form below to receive our appreciation gift.\n<\/p>\n<p><strong>APPRECIATION GIFT INFORMATION<\/strong>\n<\/p>\n<p>Patient number:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ma-so-benh-nhan\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"ma-so-benh-nhan\" \/><\/span>\n<\/p>\n<p>Company code (If for corporate health check):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ma-cong-ty\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ma-cong-ty\" \/><\/span>\n<\/p>\n<p><strong>Clinic branch you reviewed:<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"chi-nhanh\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"chi-nhanh\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"37-39 Lu\u031bo\u031bng \u0110i\u0323nh Cu\u0309a\">37-39 Lu\u031bo\u031bng \u0110i\u0323nh Cu\u0309a<\/option><option value=\"20-20Bis-22 \u0110inh Ti\u00ean Ho\u00e0ng\">20-20Bis-22 \u0110inh Ti\u00ean Ho\u00e0ng<\/option><option value=\"135A Nguye\u0302\u0303n Va\u0306n Tro\u0302\u0303i\">135A Nguye\u0302\u0303n Va\u0306n Tro\u0302\u0303i<\/option><option value=\"1056 Nguy\u1ec5n V\u0103n Linh\">1056 Nguy\u1ec5n V\u0103n Linh<\/option><\/select><\/span>\n<\/p>\n<p><strong>Full name *:<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ten-khach-hang\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ten-khach-hang\" \/><\/span>\n<\/p>\n<p><strong>Email address *:<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dia-chi-email\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"dia-chi-email\" \/><\/span>\n<\/p>\n<p><strong>Phone number *:<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"so-dien-thoai\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"so-dien-thoai\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control has-spinner wpcf7-submit\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\t\t<\/div>\n\t\t\t<\/div>\n\n\t\n\n<style>\n#row-1136439877 > .col > .col-inner {\n  padding: 0px 15px 0px 15px;\n}\n<\/style>\n<\/div>\n\t\t<\/div>\n\t\t\n<style>\n#col-212386926 > .col-inner {\n  padding: 50px 20px 0px 20px;\n  margin: -0 0px 0px 0px;\n}\n@media (min-width:550px) {\n  #col-212386926 > .col-inner {\n    padding: 50px 20px 30px 20px;\n    margin: 0 0px 0px 0px;\n  }\n}\n@media (min-width:850px) {\n  #col-212386926 > .col-inner {\n    padding: 66px 5% 16px 5%;\n    margin: -135px 0px 0px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n<\/div>\n<div class=\"row row-collapse row-full-width\"  id=\"row-1342710418\">\n\n\t<div id=\"col-1791305180\" class=\"col small-12 large-12\"  >\n\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t\t\n<style>\n#col-1791305180 > .col-inner {\n  padding: 0px 30px 0px 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